What if your last breath was only a poor assumption, a supposition? What if your family, the doctor, the coroner were all wrong, and you found yourself buried alive? You’d scratch and claw, scream and shout, and no one—no one—would hear you. There’s a name for this feeling: taphophobia, the overwhelming fear of being buried alive.

For centuries there have been stories, many of them myths, about people who met this panic-inducing fate. And real mistakes have indeed happened. According to Christine Quigley in her book The Corpse: A History, “in the early 1900s, a case of premature burial was discovered an average of once a week.” Once a week! That’s not just something to worry about—it’s something to get to work on preventing. So, how to make sure that the dead are really dead?

There’s always the ancient Roman method where mourners waited eight days to bury a body, giving the supposed deceased ample time to snap out of it. But maybe this seems far too passive. Enterprising taphophobes throughout history, and especially in the 19th century, have deployed a wide array of methods to ensure that dead means dead.

The Housecall

Fearing a premature burial, Hannah Beswick, an 18th-century English woman, left her entire estate to her doctor, Charles White, with just one stipulation: Her body could never be buried. Never. Instead, White was required to check on her corpse every day until he could be sure, really sure, that she was dead. This was a lot to ask, and at some point, White embalmed her body. He kept her mummified remains in his collection of anatomical specimens, and every day, for several years, the good doctor and two witnesses unveiled Beswick and made sure she was still dead. He later moved her body into an old clock case, and as Jan Bondeson writes in his book A Cabinet of Medical Curiosities, the doctor opened the case “once a year to see how his favorite patient was doing.”

The Security Coffin

U.S. patent number 81,437 was issued in 1868. This particular invention was for a security coffin, which came with all the bells and whistles the not-quite-dead-yet could ever need. The design includes a rope, ladder, and bell. Wake up in the coffin? Ring the bell that has helpfully been attached to the rope you’re holding. Nobody around to hear that bell? Try the ladder, which inventor Franz Vester imagined would allow a person to “ascend from the grave.”

The Grave Window

Like Hannah Beswick, Timothy Clark Smith, a Vermont taphophobia sufferer, decided to rely on others to make sure his death wasn’t announced too early. Smith asked to have a window installed on his grave, “six feet above him and centered squarely on his face,” when he died. Today the glass has clouded with age and it’s impossible to get a look at Smith, but imagine a breathy fog covering the glass, and Smith waiting for someone to notice. Of course, by all accounts Smith never had to have the assistance of a helpful passerby, and he died without incident in 1893.

The Easy-Opener

How, exactly, would the newly awakened lift those heavy coffin lids? Johan Jacob Toolen had it covered. His 1907 patent understood that the prematurely buried might be a little tired and incorporated easy-open lids so that the presumed dead wouldn’t have to struggle for freedom. His design was tailor-made for the self-reliant not-dead person. “With very slight exertion on his part,” Toolen explained, the apparently, but not really, dead “can immediately obtain a supply of fresh air and may afterwards leave the coffin.”

The Emergency Airway

Forward-thinking safety-coffin designers thought of everything. Gael Bedl’s 1887 design came equipped with an air pipe that would be opened if there were movement in the coffin. It also featured an “electric alarm apparatus,” which emitted an audible sound when the air pipe engaged. Bedl’s patent application noted that the air pipe could be made of any decorative material. The day’s been tough enough, being buried alive and all, so no need to sacrifice style.

The Completist Approach

William Tebb was a busy man in 1896. The businessman had devoted much of his life to his various pet causes (animal rights, anti-war, anti-vaccines), but one meeting in particular gave Tebb a chance to step into a role as advocate for the prematurely buried.

Tebb met Roger S. Chew, a doctor who, through the eagle-eyed observations of a family member, narrowly avoided an early grave himself, in the early 1890s. After surviving his brush with burial, Chew devoted himself to medicine and to saving others from his almost-fate. Meeting Chew sparked something in Tebb, and in 1896 he founded the London Association for the Prevention of Premature Burial. Tebb, along with Edward Vollman (himself a survivor of a near-burial), eventually published the book Premature Burial and How It May Be Prevented in 1905.

The book outlined the various ways one might be mistaken for dead (trance, catatonic state, “human hibernation”), and provided case studies of humans and animals who, although thought dead, were revived. The book also included various techniques that had been used in the past (with varying success) to prevent this from happening. The authors explored every option, from using fire to blister the hand of the presumed dead person (which, they admitted, might not be effective because the person may be so out of it that they may not respond “even to the application of red hot irons”) to injecting the presumed dead with morphine or strychnine, which, well, if they weren’t dead before …

Premature Burial also explored artificial respiration and electric shock, which were both new ideas at the time. Ultimately, the authors admitted that all of their work might not actually be that effective. Dead would always be dead to the unimaginative and, as they wrote, “the appearance of death is generally taken for its reality.” When Tebb died, he didn’t take any chances. He was cremated one week later.

Our fear of being trapped in an untimely burial plot isn’t just a lingering 19th-century fascination. As recently as 2013, designs for coffins and instruments that claim to prevent premature burial have been submitted. Somewhere deep inside all of us is a lingering worry that what was supposed to be a final resting place might actually be what kills you.

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